Shulkin, who was approved by a 100-0 vote in the Senate about 14 months ago, became the second top VA executive forced out of office in less than four years. Veterans groups and a series of prominent lawmakers had petitioned Trump to keep Shulkin in place in recent weeks, arguing his tenure was mostly characterized by significant, meaningful reforms.

But Trump in a series of tweets on Wednesday evening, Trump announced he intended to nominate presidential physician Rear Adm. Ronny Jackson to replace Shulkin, and to move Under Secretary of Defense for Personnel and Readiness Robert Wilkie into the interim leadership post while the transition occurs.

I am pleased to announce that I intend to nominate highly respected Admiral Ronny L. Jackson, MD, as the new Secretary of Veterans Affairs....

Jackson, a 23-year sailor and a respected military physician, is largely an unknown in the veterans community. None of his official biography mentions work with the department, or in veterans issues.

He is an Iraq War veteran how deployed as an emergency medicine physician with the Surgical Shock Trauma Platoon in Taqaddum, Iraq, in 2005. He served as the White House doctor for former presidents George W. Bush and Barack Obama, directing health care for not only the commander-in-chief but their senior staff and Cabinet officials.

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He’ll now take over the second-largest federal department, with a staff of more than 360,000 employees who handle health care needs of more than 9 million veterans.

Senate Veterans Affairs Committee Chairman Sen. Johnny Isakson, R-Ga., said after the announcement that he looks forward “to meeting Admiral Jackson and learning more about him.” Committee ranking member Sen. Jon Tester, D-Mont., expressed similar unfamiliarity with Jackson’s background, saying he hopes to find out “if he is up for the job.”

Rear Adm. Ronny Jackson, physician to President Donald Trump, speaks during the daily White House press briefing on Jan. 26, 2018, at the James Brady Press Briefing Room of the White House. (Alex Wong/Getty Images)

Both men are currently working with House and administration officials on an ambitious VA health care overhaul, one that has been entangled in debates of privatization of department responsibilities and how much VA funding should be shifted to private-care options for veterans.

Shulkin was seen as a central figure in those discussions, although his positions on the issue lead in part to his dismissal.

Sen. Richard Blumenthal, D-Conn., promised serious scrutiny for the new nominee on those issues.

“This firing threatens the VA’s vital mission to provide first-rate health care, employment services, and essential benefits that we owe to our nation’s heroes, regardless of who is president,” he said in a statement. “It threatens to deepen and spread chaos and dysfunction prevalent in this administration to veterans’ services that should be enhanced, not diminished.”

House Veterans’ Affairs Committee ranking member Tim Walz, D-Minn., in a statement said he didn’t know much of Jackson’s background, “but I know he has a lot of work to do following the chaos and dysfunction President Trump has created at the VA.”

“The VA has a broad mission and the secretary must be someone who is imminently qualified to lead the nation’s second largest cabinet agency,” said Carl Blake, executive director of Paralyzed Veterans of America.

“In particular, reforming VA’s health care system to better serve the needs of veterans and their families is of great importance. We encourage the Senate Committee on Veterans’ Affairs to take these concerns very seriously as it considers Admiral Jackson’s nomination.”

But Sarah Verardo, executive director of conservative-backed Independence Fund, said the move can help move the department out of its current controversies and refocus leaders on reform efforts.

“Obviously, as the White House physician, Admiral Jackson has the president’s trust, which will be vital in bridging the final barriers to getting real VA health care choice enacted into law,” she said. “Who is or is not the secretary is not important when this president has laid out such a clear and compelling vision for the VA. What matters is the president has a secretary with whom he can work effectively to achieve that vision.”

Nat’l Cmdr Rohan on firing of @DeptVetAffairs Sec. Shulkin: “Secretary Shulkin has acted in the best interests of America’s veterans and was making meaningful, positive changes at the VA. We wish Secretary Shulkin well on his next venture. (thread)

No timeline has been set for confirmation hearings for Jackson. The process typically takes several months, but that could be extended or sped up based on Congress’ shortened legislative schedule this year due to the November mid-term elections.